Bone diseases and injuries are highly incapacitating and result in a high demand for tissue substitutes with specific biomechanical and structural features. Tissue engineering has already proven to be effective in regenerating bone tissue but has not yet been able to become an economically viable solution due to the complexity of the tissue which is very difficult to be replicated, eventually requiring the utilization of highly labour-intensive processes. Process automation is seen as the solution for mass production of cellularized bone tissue substitutes at an affordable cost by being able to reduce human intervention as well as reducing product variability. The combination of tools such as medical imaging, computer-aided fabrication and bioreactor technologies, which are currently used in tissue engineering, shows potential to generate automated production ecosystems which will in turn enable the generation of commercially available products with widespread clinical application.